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Biomedical subjects

M M Godbole

Publications and source records attributed to M M Godbole.

12 recordsLinked to original sources

Learning disabilities and poor motivation to achieve due to prolonged iodine deficiency.

The effect of prolonged iodine deficiency on learning and motivation was studied. One hundred male children--matched for age, socioeconomic status, and formal education--were selected from both severely iodine-deficient (SID) and mildly iodine-deficient (MID) villages. Mean urinary iodine excretion was significantly lower in the SID than in the MID group (219.84 +/- 57.52 compared with 449.14 +/- 32.31 nmol/L, P < 0.001). The serum thyroxine concentration was significantly lower (90.36 +/- 6.46 compared with 123.70 +/- 15.42 nmol/L, P< 0.001) and serum thyroid-stimulating hormone (TSH) was significantly higher in the SID group than in the MID group (6.23 +/- 0.34 compared with 4.85 +/- 0.28 mU/L, P< 0.01). The children were administered maze, verbal, and pictorial learning tasks and a test of motivation. The results showed that SID children are slow learners compared with MID children. In both groups the rate of learning over trials was superior in younger (aged 9-12 y) children although the initial performance of older (aged 12-15 y) children was better (P < 0.01). SID children scored significantly lower than MID children on the achievement motivation scale (P < 0.01). The results are suggestive of neural impairment as well as poor sociopsychologic stimulation, resulting in learning disability and lowered achievement motivation. Unless iodine nutrition is improved in the community as a whole, these abnormalities may prevent millions of children from the SID areas from achieving their full potential even if learning opportunities are made available to them.

Achievement

Differential expression of alpha- and beta-thyroid hormone receptor genes in the developing rat brain under hypothyroidism.

One of the most alarming observations of iodine deficiency disorders (IDD) is neurological cretinism which is caused due to lack of T3 during the crucial stages of brain development. We have developed an iodine-deficient rat model to study the pattern of T3 receptor genes expression in the brain during postnatal development under iodine deficiency. We observed increased expression of c-erbA-alpha 2 and -beta 1 T3 receptor transcripts while c-erbA-alpha 1 remains unchanged in the brain of the iodine-deficient neonates compared with their euthyroid counterparts. Up-regulation of the beta 1 form in the developing brain under iodine deficiency is suggestive of an adaptive process coming into play to protect it from the damages that are inflicted due to hypothyroidism. Though the significance of the increased alpha 2 form in the iodine-deficient rat brain has not yet been ascertained, it can be conjectured that it acts as a homeostatic control over 'functional receptor' (namely beta 1) under developmental hypothyroidism.

Animals

Organochlorine pesticide exposure and thyroid function: a study in human subjects.

We examined the serum levels of thyroxine and thyroid stimulating hormone in 103 rural subjects with respect to blood levels of organochlorine pesticide and occupation. We found that 24.3% of study subjects had depleted thyroxine levels in association with significantly lower organochlorine pesticide residues in blood. Sex, nutritional status, thyromegaly, or handling of pesticides in the course of work were not found to be factors contributing to depleted thyroxine levels.

Adult

Reversible impairment of glucose tolerance in patients with endemic fluorosis. Fluoride Collaborative Study Group.

Endemic fluorosis is a condition resulting from prolonged ingestion of drinking water which contains excess fluoride. Studies on rats have suggested that fluoride toxicity may produce glucose intolerance and abnormalities in insulin secretion. We studied glucose and insulin profiles following an oral glucose load in patients with endemic fluorosis. Twenty-five young adults (age range, 15-30 years) with endemic fluorosis, and an equal number of matched healthy control subjects with normal fluoride intake were studied. Impaired glucose tolerance was demonstrated in 10 of 25 (40%) patients with endemic fluorosis. Patients with impaired glucose tolerance had significantly higher fasting serum immunoreactive insulin (p < 0.05), higher fasting serum fluoride (p < 0.001), and a significantly lower fasting glucose to insulin ratio than that in patients with normal glucose tolerance (p < 0.001) or control subjects (p < 0.05). The fasting serum fluoride levels correlated positively with the area under the glucose curve (r = 0.80, p < 0.01) in patients with impaired glucose tolerance. Interestingly these abnormalities could be reversed when the village was provided drinking water with fluoride levels within acceptable limits. The present study shows that chronic fluoride toxicity in humans could result in significant abnormalities in glucose tolerance which are reversible upon removal of the excess fluoride.

Adolescent

5'-Monodeiodinase activity in developing human cerebral cortex.

Iodine status of aborted fetuses (11-25 wk gestation) was determined on the basis of maternal thyroid status and urinary iodine excretion. Fetal cerebral cortex thyroxin and 3,5,3'-triiodothyronine (T3) contents peaked at 15-18 wk gestation and then fell in iodine sufficiency. In mild iodine deficiency T3 concentration was maintained at a higher level until week 22, although it were still significantly less than in the iodine-sufficient group. Reverse T3 (rT3) rose from 11 to 22 wk gestation without any effect of iodine status. The activity of 5' and 5-monodeiodinase also increased from 11 to 22 wk gestation, with 5' monodeiodinase activity significantly increased by mild and moderate iodine deficiency. In contrast, cerebral cortex 5-monodeiodinase activity was significantly lower in moderate iodine deficiency at 15-18 wk gestation. The observations indicate that cerebral cortex 5' and 5 monodeiodinase activities are modulated in iodine deficiency to enhance T3 production from thyroxin (T4) during the period that coincides with neuroblastogenesis.

Cerebral Cortex

Late-onset adrenal hyperplasia in north Indian hirsute women.

The occurrence of late-onset congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency was studied in 60 consecutive hirsute women by means of adrenocorticotrophin (ACTH)-stimulated serum 17-hydroxyprogesterone (17-OHP) levels. Five (8.3%) women had an exaggerated response (ACTH-stimulated 17-OHP 3,160 +/- 560 ng/dl). All of them had regular periods and 3 were virilized. The other 2 were indistinguishable from those with idiopathic hirsutism or polycystic ovarian disease.

17-alpha-Hydroxyprogesterone

Iodine deficiency and neonatal hypothyroidism.

The incidence of neonatal hypothyroidism, as reflected in cord-blood thyroxine and thyrotropin levels, varied from 0.6% to 13.3% in iodine-deficient and normal regions of India (selected districts of Uttar Pradesh and Kerala and the city of Delhi), depending on the degree of environmental iodine deficiency. In populations with a high incidence of neonatal hypothyroidism, an increased prevalence of nerve deafness and a shift to the left in the distribution of IQ scores (towards lower scores) have been demonstrated. These indications of mild brain damage suggest that nutritional iodine deficiency can present in other ways than goitre or cretinism. Determination of the incidence of neonatal hypothyroidism using dried cord-blood spot screening appears to be the most useful and reliable method to assess the risk of brain damage in iodine-deficient areas.

Congenital Hypothyroidism

Single daily dose of carbimazole in the treatment of hyperthyroidism.

BACKGROUND: The antithyroid drugs, methimazole and carbimazole, are conventionally used in divided daily doses. However, these drugs have a longer intrathyroidal than a plasma half-life. We undertook this prospective, controlled study, in an area of mild iodine deficiency, to compare the efficacy of a single daily dose of carbimazole with divided doses in the treatment of hyperthyroidism. METHODS: Nineteen patients with hyperthyroidism received 30 mg of carbimazole daily at bed time (group A) while 14 received 10 mg of carbimazole every 8 hours (group B). These patients were assessed clinically and biochemically by estimation of serum total thyroxine, total triiodothyronine and thyrotropin before and 1, 2, 3, 4 and 6 weeks after treatment. RESULTS: There was no significant difference between mean baseline concentrations of thyroxine and triiodothyronine. After 1, 2, 3, 4 and 6 weeks there was a decline in their concentrations which was similar in both groups (p > 0.05). Euthyroidism was achieved in 4.6 +/- 1.4 weeks (range 2-6 weeks) in group A and in 3.8 +/- 1.2 weeks (range 3-6 weeks) in group B (p > 0.05). CONCLUSIONS: We conclude that carbimazole in a single daily dose is an effective method for treating hyperthyroidism in an area of mild iodine deficiency and its efficacy is comparable to divided dose therapy. This practical and acceptable method of treatment can be specially useful in patients who find it difficult to remember to take divided doses.

Adolescent

Iopanoic acid as an adjunct to carbimazole in the management of hyperthyroidism.

BACKGROUND: The thiourea drugs take a few weeks to control the symptoms of hyperthyroidism whilst iodine containing radiographic contrast agents (iopanoic acid and sodium ipodate) have a more rapid effect. There is no report on the use of iopanoic acid administered in conjunction with carbimazole, so we evaluated the efficacy of this combination in the early medical management of patients with hyperthyroidism. METHODS: Thirty hyperthyroid patients diagnosed by clinical and biochemical criteria were randomized into two treatment groups. Group A (n = 16) received iopanoic acid (500 mg orally twice a day for the first 3 weeks) and carbimazole (30 mg orally in three divided doses) while group B (n = 14) received carbimazole alone. Clinical examination and estimation of serum total T3, total T4 and TSH were done by radioimmunoassay at the start of therapy, weekly for 4 weeks and then at 6, 8 and 12 weeks. RESULTS: In the initial 3 weeks, iopanoic acid induced a significantly greater fall in mean serum total T3 levels (Z = 2.298, p < 0.02) and a slower fall in mean serum total T4 (Z = 2.396, p < 0.05) in group A patients compared to those in group B. This was accompanied by earlier clinical improvement in group A patients. The mean serum total T3 and T4 values rose to higher levels in group A at 4 weeks, one week after discontinuation of iopanoic acid. At the end of 12 weeks, however, there was no significant difference in the mean serum total T3 and T4 levels between the two groups (p > 0.05). Biochemical euthyroidism (i.e. total T3 < 3 nmol/L and total T4 < 170 nmol/L) was achieved later in group A patients than in group B (10.4 +/- 5.0 weeks v. 3.6 +/- 1.2 weeks, p < 0.0001). CONCLUSIONS: Iopanoic acid given together with carbimazole induces rapid clinical improvement in hyperthyroid patients than carbimazole alone. However, the delayed achievement of euthyroidism may preclude its routine use in the management of patients with hyperthyroidism except in those with thyrotoxic emergencies.

Adult

Extraovarian endocrine abnormalities in north Indian women with premature ovarian failure.

BACKGROUND: Premature ovarian failure is a rare syndrome characterized by cessation of menstruation before 35 years of age associated with an elevated gonadotropin level (serum follicle stimulating hormone > 40 IU/L) and oestrogen deficiency. Premature ovarian failure is often the result of an autoimmune process and involvement of other endocrine glands has been reported but available studies are hampered by a lack of uniformity in diagnostic criteria. METHODS: The endocrine profile of 37 north Indian women with premature ovarian failure was studied. The investigations included measurement of serum follicle stimulating hormone, luteinizing hormone, oestradiol, prolactin, total thyroxine, total triiodothyronine and thyroid stimulating hormone. To assess adrenocortical reserve, adrenocorticotropic hormone stimulated plasma cortisol levels were estimated. RESULTS: Eighteen (49%) patients had extraovarian endocrine abnormalities. Eight (22%) had abnormal thyroid function tests and 12 of 29 (41%) patients tested for adrenocortical reserve showed impaired response of plasma cortisol to adrenocorticotropic hormone stimulation. CONCLUSION: Extraovarian endocrine (especially adrenocortical) involvement is frequent in patients with premature ovarian failure. Because none of the patients had overt clinical evidence of thyroid or adrenocortical disease, we suggest that tests for thyroid and adrenal function be performed routinely in females presenting with premature ovarian failure.

Adolescent